European Archives of Oto-Rhino-Laryngology最新文献

{"title":"Unveiling the relation between swallowing muscle mass and skeletal muscle mass in head and neck cancer patients.","authors":"Javier Hurtado-Oliva, Lucy Núñez-Miranda, Aniek T Zwart, Jeroen Vister, Boudewijn E C Plaat, Roel J H M Steenbakkers, Anouk van der Hoorn, Inge Wegner, Gyorgy B Halmos","doi":"10.1007/s00405-025-09207-0","DOIUrl":"10.1007/s00405-025-09207-0","url":null,"abstract":"<p><strong>Purpose: </strong>Sarcopenia, characterized by loss of skeletal muscle mass (SMM) and strength, often leads to dysphagia in the elderly. This condition can also worsen treatment outcomes in head and neck cancer (HNC) patients, who are susceptible to swallowing difficulties. This study aimed to establish the correlation between swallowing muscle mass (SwMM) and SMM in HNC patients.</p><p><strong>Methods: </strong>Data from 157 HNC patients in the OncoLifeS biobank of the University Medical Center Groningen were analyzed using pre-treatment neck CT scans. The SwMM was assessed by the cross-sectional area (CSA) of the tongue complex muscles (TCM), and SMM was indicated by the skeletal muscle index (SMI), calculated from corrected CSA at the third lumbar vertebra (L3). Correlations between SwMM and SMM were analyzed using Pearson or Spearman tests, and multivariable linear regression with SMI as dependent variable was performed.</p><p><strong>Results: </strong>SwMM was moderately correlated with SMI (r = 0.600, p < 0.001), CSA at C3 (r = 0.538, p < 0.001), and CSA at L3 (r = 0.651, p < 0.001). The CSA at C3 strongly correlated with SMI (r = 0.871, p < 0.001). In multivariable regression analysis, age, sex, and weight were strong predictors of SMI, while the TCM area was a less robust predictor (p = 0.059). Models with CSA at C3 and L3 showed all variables as significant predictors (p < 0.001).</p><p><strong>Conclusions: </strong>Although SwMM was significantly correlated with SMI and holds clinical utility, it is not strong enough to be considered interchangeably with C3 for predicting SMI, suggesting that swallowing muscles represent a different entity than skeletal muscles and not reflect accurately the general muscle mass.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3173-3182"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post mortem cadaveric and imaging mapping analysis of the influence of cochlear implants on cMRI assessment regarding implant positioning and artifact formation.","authors":"P Arnold, L Fries, R L Beck, S Granitzer, M Reich, A Aschendorff, S Arndt, M C Ketterer","doi":"10.1007/s00405-024-09164-0","DOIUrl":"10.1007/s00405-024-09164-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;In times of an aging society and considering the escalating health economic costs, the indications for imaging, particularly magnetic resonance imaging (MRI), must be carefully considered and strictly adhered to. This cadaver study aims to examine the influence of cochlear implant (CI) on the assessment of intracranial structures, artifact formation, and size in cranial MRI (cMRI). Furthermore, it seeks to evaluate the potential limitations in the interpretability and diagnostic value of cMRI in CI patients. Additionally, the study investigates the imaging of the brain stem and the internal ear canal and the feasibility of excluding cholesteatomas in cMRI for CI patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Two cadaveric specimens were implanted with cochlear implants at varying angular positions (90°, 120°, and 135°), both unilaterally and bilaterally, with and without magnet in situ. MRI acquisition consisted of sequences commonly used in brain MRI scans (T&lt;sub&gt;1&lt;/sub&gt;-MP-RAGE, T&lt;sub&gt;2&lt;/sub&gt;-TSE, T&lt;sub&gt;1&lt;/sub&gt;-TIRM, DWI, CISS). Subsequently, the obtained MRI images were manually juxtaposed with a reference brain from the Computational Anatomy Toolbox CAT12. The size and formation of artifacts were scrutinized to ascertain the assessability of 22 predefined intracranial structures. Furthermore, the internal auditory canal, middle ear and mastoid were evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The cadaveric head mapping facilitated the analysis of all 22 predefined intracranial structures. Artifacts were assessed in terms of their minimum and maximum impact on image comparability. Image quality and assessability were stratified into four categories (0-25%, 25-50%, 50-75%, and 75-100% of assessability restriction). The visualization of the central, temporal, parietal, and frontal lobes was contingent upon CI positioning and the choice of imaging sequence. Diffusion-weighted cMRI proved inadequate for monitoring cholesteatoma recurrence in ipsilateral CI patients, regardless of magnet presence. The ipsilateral internal auditory canal was inadequately visualized in both magnet-present and magnet-absent conditions. We divided our results into four categories. Category 3 (orange) indicates considerable limitations, while category 4 (red) indicates no interpretability, as the image is entirely obscured by artifacts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study provides detailed predictive power for the assessability and therefore the relevance of performing cMRIs in CI patients. We advocate consulting the relevant CI center if artifact overlay exceeds 50% (categories 3 and 4), to evaluate magnet explantation and reassess the necessity of cMRI. When suspecting cholesteatoma or cholesteatoma recurrences in patients with ipsilateral cochlear implants, diagnostic investigation should preferably be pursued surgically, as the necessary MRI sequences are prone to artifact interference, even in the absence of a magnet","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"2947-2958"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of noise on listening effort in children as measured using different methods: a systematic review and meta-analyses.","authors":"Gudambe Nellithaya Spoorthi, Ajith Kumar Uppunda, Mohan Kumar Kalaiah, Usha Shastri","doi":"10.1007/s00405-025-09232-z","DOIUrl":"10.1007/s00405-025-09232-z","url":null,"abstract":"<p><strong>Purpose: </strong>Listening effort increases as background noise levels rise, affecting both children and adults. Understanding the impact of increased listening effort and identifying effective methods to estimate it in children is crucial, as higher listening effort can hinder learning. This systematic review and meta-analysis examined the effects of noise on listening effort, as measured using various methods, in children aged 5 to 13 years with normal hearing.</p><p><strong>Methods: </strong>Four scientific databases, PubMed, Scopus, Cochrane Library, and Web of Science, were searched to retrieve 23 eligible articles. The methodological quality of the studies was assessed using Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Meta-analysis was performed according to different methods of listening effort [behavioral (single-task paradigm and dual-task paradigm), subjective ratings, and physiological (pupillometry)].</p><p><strong>Results: </strong>Single-task paradigm and subjective ratings showed a medium effect of noise on listening effort, which was significant. Dual-task paradigm and pupillometry did not show statistically significant effects of noise on listening effort. Further, speech perception tasks show a greater effect of noise on listening effort as compared to listening comprehension.</p><p><strong>Conclusions: </strong>Single-task paradigm and subjective rating methods revealed the negative effect of noise on listening effort during spoken language processing in children between 5-13 years of age. Thus, a combination of these two methods might provide useful information regarding the effect of noise on this population. The heterogeneity in the findings could be due to the multidimensional nature of listening effort and lack of construct validity of the methods used to assess listening effort.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"2855-2886"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted vs. manual cochlear implant electrode array insertion in four children.","authors":"Vittoria Sykopetrites, Eleonora Sica, Raffaella Moalli, Davide Cocozza, Sergio Razza, Eliana Cristofari","doi":"10.1007/s00405-024-09195-7","DOIUrl":"10.1007/s00405-024-09195-7","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluate the feasibility and safety of a robotic electrode insertion in pediatric cochlear implantation and compare the results with manually inserted electrodes in the same subject.</p><p><strong>Methods: </strong>Retrospective case series review of four children who underwent bilateral cochlear implantation with the same array: on one side, the array was inserted using the robot, while on the other side the array was inserted manually. Behavioural and electrophysiological measures were compared.</p><p><strong>Results: </strong>The duration of surgery when the robot was adopted was significantly longer than when a manual insertion was performed (161.15 ± 27.59 minutes vs. 122.6 ± 37.71 min, paired t-test: p = 0.029). Moreover, robotic electrode insertion was significantly slower (average insertion speed 0.3 mm/second vs. 0.52 ± 0.17 mm/s, paired t-test: p = 0.0055). On radiologic examination, none of the arrays was misplaced. Impedance, both at activation and at one year of cochlear implant use, was significantly lower on the robotic side in monopolar mode compared to the manual side (mean 9.64 ± 2.41kΩ and 9.97 ± 1.39 kΩ vs. 10.43 ± 2.69 kΩ and 10.94 ± 1.11 kΩ, paired t test, p = 0.0251 and p = 0.0061, respectively). Both the threshold stimulation level and the most comfortable loud stimulation level were significantly lower in the robotic inserted ear compared to the manually inserted ear (mean 108.1 ± 5.98 and 169 ± 4.84 vs. 112.1 ± 7.43 and 172.7 ± 6.83, respectively, paired t test p < 0.0001).</p><p><strong>Conclusions: </strong>Although we present a small group of cases, our results show how robot-based array insertion is associated with lower impedance and stimulation levels compared to manually inserted arrays.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3019-3025"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewing the efficacy, safety and aesthetic outcome of barbed suture use in neck dissection.","authors":"Emad A M Msallam, Benyamin Alam, Tauheed Akram, Amir Reza Akbari","doi":"10.1007/s00405-025-09233-y","DOIUrl":"10.1007/s00405-025-09233-y","url":null,"abstract":"","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3387"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of nasal saline irrigation in conjunction with intranasal steroids in allergic rhinitis.","authors":"Omvir Singh Chahar, Sheetal Raina, Ahmad Rizwan, Supreet Singh Nayyar, Shailendra Tripathi, Akshay Bhatnagar, Ombir Singh, Nandini Bisht, Mohneesh Dixit","doi":"10.1007/s00405-025-09392-y","DOIUrl":"10.1007/s00405-025-09392-y","url":null,"abstract":"<p><strong>Aim: </strong>To study the efficacy of nasal saline irrigation combined with intranasal corticosteroids in treating Allergic Rhinitis and compare it with intranasal corticosteroids alone.</p><p><strong>Methodology: </strong>A prospective, randomized trial conducted at a tertiary care center. Symptomatic individuals diagnosed with Allergic Rhinitis were included. The control group received fluticasone propionate nasal spray (200 mcg/day) and the treatment group received fluticasone propionate nasal spray (200 mcg/day) along with nasal saline irrigation with isotonic normal saline (50 ml/nostril with each irrigation thrice a day). The two groups were followed up for 12 weeks. The outcome was compared using a patient-reported experience measure \"Allergic rhinitis scoring system\".</p><p><strong>Results: </strong>A total of 120 patients (60 in each group) were included in the study. Pre-intervention, there were no significant differences between the two groups with the Allergic rhinitis scoring system. Post-Intervention, significant improvements were evident across all assessed symptoms: rhinorrhoea (14.93 ± 4.16 vs. 17.80 ± 3.16, p < 0.0001), sneezing (14.40 ± 3.91 vs. 18.27 ± 3.16, p < 0.0001), nasal blockage (10.47 ± 4.66 vs. 13.80 ± 4.80, p = 0.0002), nasal pruritus (17.93 ± 3.17 vs. 19.13 ± 1.96, p = 0.0140), ocular pruritus (18.60 ± 2.84 vs. 19.13 ± 2.22, p = 0.2537), and total Allergic rhinitis scoring system score (77.00 ± 9.79 vs. 88.13 ± 7.70, p < 0.0001).</p><p><strong>Conclusion: </strong>Nasal saline irrigation used in conjunction with intranasal corticosteroids more effectively alleviates all symptoms of Allergic rhinitis. However, there was no significant difference in ocular pruritus in both groups.</p><p><strong>Trial registration: </strong>Trial registered with Clinical trial registry-India, CTRI/2023/01/048641. URL: https://ctri.nic.in/Clinicaltrials/main1.php?EncHid=44058.73881 .</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3097-3101"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of improving vocal fold pathology image classification with synthetic images generated by DDPM-based GenAI: a pilot study.","authors":"Iman Khazrak, Shahryar Zainaee, Mostafa M Rezaee, Mehran Ghasemi, Robert C Green","doi":"10.1007/s00405-025-09443-4","DOIUrl":"https://doi.org/10.1007/s00405-025-09443-4","url":null,"abstract":"<p><strong>Background: </strong>Voice disorders (VD) are often linked to vocal fold structural pathologies (VFSP). Laryngeal imaging plays a vital role in assessing VFSPs and VD in clinical and research settings, but challenges like scarce and imbalanced datasets can limit the generalizability of findings. Denoising Diffusion Probabilistic Models (DDPMs), a subtype of Generative AI, has gained attention for its ability to generate high-quality and realistic synthetic images to address these challenges.</p><p><strong>Purpose: </strong>This study explores the feasibility of improving VFSP image classification by generating synthetic images using DDPMs.</p><p><strong>Methods: </strong>404 laryngoscopic images depicting VF without and with VFSP were included. DDPMs were used to generate synthetic images to augment the original dataset. Two convolutional neural network architectures, VGG16 and ResNet50, were applied for model training. The models were initially trained only on the original dataset. Then, they were trained on the augmented datasets. Evaluation metrics were analyzed to assess the performance of the models for both binary classification (with/without VFSPs) and multi-class classification (seven specific VFSPs).</p><p><strong>Results: </strong>Realistic and high-quality synthetic images were generated for dataset augmentation. The model first failed to converge when trained only on the original dataset, but they successfully converged and achieved low loss and high accuracy when trained on the augmented datasets. The best performance was gained for both binary and multi-class classification when the models were trained on an augmented dataset.</p><p><strong>Conclusion: </strong>Generating realistic images of VFSP using DDPMs is feasible and can enhance the classification of VFSPs by an AI model and may support VD screening and diagnosis.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ulcerative supraglottitis - a unique presentation of COVID-19 infection.","authors":"Shmuel Wechsler, Jacob Pitaro, Nathan Shlamkovich, Limor Muallem Kalmovich, Haim Gavriel","doi":"10.1007/s00405-025-09458-x","DOIUrl":"https://doi.org/10.1007/s00405-025-09458-x","url":null,"abstract":"<p><strong>Objective: </strong>COVID-19 has been previously considered a lower respiratory tract disease. However, as the disease has evolved, studies have described its upper respiratory involvement. This study's objective was to present, for the first time, a series of patients with supraglottitis with unique characteristics of coronavirus disease.</p><p><strong>Methods: </strong>This retrospective single-center case study included patients who were referred to the Emergency Department (ED) between June 1, 2022, and September 1, 2023, with clinical and endoscopic findings consisting of supraglottitis and positive PCR results for SARS-CoV-2.</p><p><strong>Results: </strong>Ten patients met the inclusion criteria. The mean age was 61. Six (60%) patients had comorbidities. Two (20%) patients were not vaccinated, whereas the others were vaccinated between one and five times. All patients presented with odynophagia, and most had fever and hoarseness. Laryngeal findings included epiglottic ulcers in the inner portion of the epiglottis in all patients, with varying degrees of severity. Presentation with a choking sensation, hoarseness, and elevated CRP and WBC levels may indicate a more severe disease course.</p><p><strong>Conclusion: </strong>The latest COVID-19 variants can manifest with clinical and endoscopic findings of acute supraglottitis, with specific endoscopic characteristics of the larynx. Physicians should be aware of this clinical entity, refer suspected patients to the ED, and perform urgent laryngoscopy, while the otolaryngologist should be aware of the specific endoscopic presentation and manage the patient accordingly.</p><p><strong>Level of evidence: </strong>4: This study was approved by the institutional review board. Approval number- 0212-23ASF- 22/09/2023.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative fluorescence in solid head and neck cancer: A scoping review.","authors":"Brian A Keith, Alejandro R Marrero-Gonzalez, Isabelle J Chau, Shaun A Nguyen, William G Albergotti, Alexandra E Kejner, Jason G Newman","doi":"10.1007/s00405-025-09442-5","DOIUrl":"https://doi.org/10.1007/s00405-025-09442-5","url":null,"abstract":"<p><strong>Purpose: </strong>Obtaining negative margins in primary tumor resection is essential to decreasing recurrence and mortality. Fluorescence imaging may aid in complete tumor removal. As fluorescent agents are still under clinical trial investigation for use in head and neck cancer (HNC), their effectiveness in intraoperative margin assessment (IMA) remains unclear. This scoping review examines the use of fluorescent-guided surgery (FGS) in the treatment of HNC, highlighting significant opportunities in this nascent field.</p><p><strong>Methods: </strong>PubMed, Scopus, CINAHL, and Cochrane Library were searched from inception through March 22, 2024. This study was conducted under PRISMA-ScR guidelines. Data on study characteristics, fluorescence and imaging techniques, imaging efficacy, and diagnostic accuracy were extracted.</p><p><strong>Results: </strong>Twenty-seven prospective studies from 2013 to 2024 on intraoperative FGS in HNC, involving 455 patients from six countries, were included. Studies ranged from preclinical to phase II trials, applying various fluorescent techniques, predominantly indocyanine green and IRDye800CW, to enhance surgical precision. Imaging assessments were conducted in-vivo, ex-vivo, or both, using a wide range of devices and taking an additional 0 to 30 min intraoperatively. Quantitative measures like signal-to-background ratio and mean fluorescent intensity suggested variable diagnostic accuracy across studies. FGS shows great potential in improving IMA, although standardization in methodologies and reporting is needed.</p><p><strong>Conclusion: </strong>This scoping review highlights the potential of intraoperative FGS to enhance treatment accuracy in solid HNC, though variability in diagnostic efficacy and a lack of standardized methodologies persist. Advancements in fluorophore technology and uniform procedural protocols are essential to optimize surgical outcomes and move towards personalized HNC interventions.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcome following primary closure of auricular lacerations.","authors":"Max Zwemstra, Simon Geerse, Maarten de Wolf, Fenna Ebbens, Cas Smits, Erik van Spronsen","doi":"10.1007/s00405-025-09453-2","DOIUrl":"https://doi.org/10.1007/s00405-025-09453-2","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the aesthetic outcomes of primary closure of auricle lacerations in the emergency department.</p><p><strong>Methods: </strong>In this prospective case study in our tertiary referral center we included all patients with an auricular laceration without complete avulsion. Wound treatment involved thorough cleaning and primary closure. Photos of the auricle were taken at various stages for evaluation. To evaluate the achieved results after 3 months, a success classification system with four classes was developed: (1) full success, no irregularities, (2) partial success, only minor irregularities, (3a) unsuccessful, major irregularities or (3b) unsuccessful, (partial) necrosis.</p><p><strong>Results: </strong>Most patients demonstrated successful outcomes (60.7% full success and 32.1% partial success), with helical involvement being associated with inferior results. The interobserver percent agreement of the classification system was 88%. The Fleiss' kappa coefficient was 0.570, p < 0.001.</p><p><strong>Conclusion: </strong>Primary closure of ear lacerations results in a high success rate. We have introduced a revised classification system to qualify the success of treatment of the auricle laceration. Involvement of the helix is correlated with inferior surgical results three months after surgical closure. Trial registration number and date of registration: reference number W21_387 # 21.432, September 9, 2021.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}